Identification of Inguinal Lymph Node Metastases from Vulval Carcinoma by Magnetic Resonance Imaging: An Initial Report

Hawnaur, J.M.; Reynolds, Karina; Wilson, Gerald S.; Hillier, V. F.; Kitchener, HC

doi:10.1053/crad.2002.1057

Cited by 51 publications

(25 citation statements)

References 10 publications

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“…Given the unreliability of the clinical assessment of groin node status, the main reason for radiologic imaging in vulval carcinoma is to assess nodal status. CT imaging and other imaging techniques such as MRI rely on size criteria to assess nodal positivity (16) . This is associated with reduced sensitivity and specificity as normal-sized nodes may contain metastases and enlarged nodes may be reactive.…”

Section: Discussionmentioning

confidence: 99%

Routine computerized tomography scanning, groin ultrasound with or without fine needle aspiration cytology in the surgical management of primary squamous cell carcinoma of the vulva

Land

Herod

Moskovic

et al. 2006

Int J Gynecol Cancer

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We set out to study whether computerized tomography (CT) scanning of the vulva and the groin and groin ultrasound scanning (USS) alone or with fine needle aspiration cytology (FNAC) (USS/FNAC) influenced or could influence the surgical management of primary squamous cell carcinoma of the vulva (SCCaV). Forty-four patients underwent surgery for primary SCCaV following radiologic imaging by one or more modalities. Patient details included the clinical assessment of the carcinoma, radiologic findings, the operation performed, and whether the decision regarding the type and extent of surgery for the vulval carcinoma and, in particular, for the groin node dissection was or could be influenced by the radiologic findings. The age range was 38-87 years, with a median of 74 years. A total of 75 groin dissections were performed. Twenty-five of the 44 patients (56.8%) did not have groin node metastasis, 14 had unilateral metastasis (31.8%), and 5 (11.4%) had bilateral metastasis. All cases with histologically proven nodal status were analyzed to compare the preoperative imaging status with the histology. The calculated sensitivity, specificity, negative predictive value, and positive predictive value for CT were 58%, 75%, 75%, and 58%, for USS alone-87%, 69%, 94%, and 48%, and for USS-guided FNAC-80%, 100%, 93%, and 100%, respectively. There was no patient in whom surgical planning for the vulval carcinoma or the groin nodes was or could be altered by the CT findings. The data do not support the routine use of CT scanning in patients with primary SCCaV, either in assessment of the primary vulval carcinoma or in detecting groin nodal metastases. For the groin nodes, USS/FNAC is superior to CT in assessing disease status. In contrast to CT, USS/FNAC may have a useful clinical role in the management of the groin nodes in vulval carcinoma.

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Section: Discussionmentioning

confidence: 99%

Routine computerized tomography scanning, groin ultrasound with or without fine needle aspiration cytology in the surgical management of primary squamous cell carcinoma of the vulva

Land

Herod

Moskovic

et al. 2006

Int J Gynecol Cancer

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“…However, the sensitivity for both groups of inguinal nodes was low (respectively, 40% and 50%), which means a high false-negative rate (24) . Another pilot study showed a specificity of 91% and a sensitivity of 89% for detection of inguinal lymph node metastases by MRI in ten patients with vulvar carcinoma (25) . Prediction of lymph node metastases in vulvar cancer 965…”

Section: Ct and Mrimentioning

confidence: 97%

Prediction of lymph node metastases in vulvar cancer: a review

Oonk¹,

Hollema²,

Hullu³

et al. 2006

Int J Gynecol Cancer

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The aim of this study was to review the literature on currently available non- and minimally-invasive diagnostic methods and analysis of primary tumor characteristics for prediction of inguinofemoral lymph node metastases in patients with primary squamous cell carcinoma of the vulva. We used the English language literature in PubMed and reference lists from selected articles. Search terms included vulvar carcinoma, prognosis, lymph node metastases, ultrasound, computer tomography, magnetic resonance imaging, positron emission tomography, and sentinel lymph node. No study type restrictions were imposed. Currently no noninvasive imaging techniques exist that are able to predict lymph node metastases with a high enough negative predictive value. A depth of invasion < or =1 mm is the only histopathologic parameter that can exclude patients for complete inguinofemoral lymphadenectomy. No other clinicopathologic parameter allows exclusion of lymph node metastases with a high enough negative predictive value. The minimally invasive sentinel node procedure is a promising technique for selecting patients for complete lymphadenectomy, but its safety has not been proven yet.

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“…Hawnaur et al 70 and Sohaib et al 71 both highlighted the potential of using MRI to detect nodal involvement with high specificities of 91% to 100%, although the sensitivities ranged from 40% to 89%. In larger studies, Singh et al 72 also found MRI to be accurate in predicting negative nodal status, whereas Bipat et al 73 found no role for MRI in evaluating lymph node involvement, with high negative predictive values of 87% and 89% for 2 separate observers.…”

Section: Vulval Cancermentioning

confidence: 99%

Magnetic Resonance Imaging in Gynecological Oncology

Harry

Deans

Ramage

et al. 2009

International Journal of Gynecological Cancer

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Magnetic resonance imaging (MRI) has become an indispensable tool in the assessment of malignant disease. With increasingly sophisticated systems and technical advancements, MRI has continued to expand its role in providing crucial information regarding cancer diagnosis and management. In gynecological malignancies, this modality has assumed greater responsibility, particularly in the evaluation of cervical and endometrial cancers. In addition to conventional imaging, innovative techniques such as dynamic contrast-enhanced MRI and diffusion-weighted MRI show promise in offering early assessment of tumor response. This paper reviews the current role of MRI in gynecological cancers and highlights the potential of novel techniques in improving patient care.

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Identification of Inguinal Lymph Node Metastases from Vulval Carcinoma by Magnetic Resonance Imaging: An Initial Report

Cited by 51 publications

References 10 publications

Routine computerized tomography scanning, groin ultrasound with or without fine needle aspiration cytology in the surgical management of primary squamous cell carcinoma of the vulva

Routine computerized tomography scanning, groin ultrasound with or without fine needle aspiration cytology in the surgical management of primary squamous cell carcinoma of the vulva

Prediction of lymph node metastases in vulvar cancer: a review

Magnetic Resonance Imaging in Gynecological Oncology

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